Coronary heart disease risk factors and menopause: a study in 1980 Tehranian women, the Tehran Lipid and Glucose Study

Objectives The menopause is associated with an increased incidence of coronary heart disease (CHD). Assessing CHD risk factors in menopausal women can shed more light on the pathogenesis of accelerated atherosclerosis after the cessation of ovarian function. Design In this study, 1980 women aged 44-69 years were selected from among 15 005 participants in the Tehran Lipid and Glucose Study (TLGS) and assessed for CHD risk factors. They were classified into three groups: premenopausal women (n = 483), aged between 44 and 50 years, without any history of menstrual irregularities; menopausal women (n = 310), with permanent cessation of menses for at least 12 months and a duration of less than 3 years; and postmenopausal women (n = 1187), with at least a 3-year history of cessation of menses. Demographic information including waist size, height, weight and systolic and diastolic blood pressures was recorded, and body mass index, low-density lipoprotein/high-density lipoprotein ratio (LDL/HDL) and waist/hip ratio were calculated. Serum total cholesterol, triglycerides and HDL were measured and an oral glucose tolerance test was performed. The LDL level was calculated using the Friedwald formula. Results Mean systolic blood pressures were 121 +/- 18, 125 +/- 20 and 136 +/- 23 mmHg (p < 0.001) and mean diastolic blood pressures were 80 +/- 10, 81 +/- 11 and 82 11 mmHg (p < 0.001) in premenopausal, menopausal and postmenopausal women, respectively. For premenopausal, menopausal and postmenopausal women, mean cholesterol levels were 215 42, 238 45 and 245 46 mg/dl (p < 0.001), respectively. HDL and LDL levels were 44 11, 48 12 and 47 11 mg/dl and 138 +/- 38, 156 +/- 41 and 161 +/- 42 mg/dl (p < 0.001) for premenopausal, menopausal and postmenopausal women, respectively. Mean LDL/HDL ratios were 3.4 +/- 1.4, 3.5 +/- 1.3 and 3.6 +/- 1.2 (p < 0.01) and mean waist measurements were 92 +/- 11, 93 +/- 12 and 95 12 cm (p < 0.001) for the same groups of women, respectively. However, body mass index, waist/hip ratio and triglycerides showed no significant differences between the three groups. Conclusion These data demonstrate an increase in CHD risk factors in a group of Tehranian women after the menopause.